Keeping me awake at night

I’ve known that I had peripheral neuropathy since early 2010 when I checked in with a podiatrist about other issues. I saw my personal doctor and he took a full battery of blood tests to determine if there was anything obvious. The results ruled out any of the “bad things” (diabetes, HIV/AIDS, etc.). He did detect a vitamin D deficiency so he had me taking mega dosages of vitamin D. Because the supplement would not have immediate effect, I did not get back to him right away and then forgot about the problem.

However, this year, I’ve noted a worsening of the symptoms (pin pricks and numbness on my feet, especially the left foot) to the point that it was keeping me from falling to sleep. Symptoms seemed to flare up about 1:00 or 2:00 am. My home medicine consisted of Aleve, restorative poses on my mat, using a tennis ball to stretch the sole of my foot, and applying ice to the foot. I tried to do some of these things before going to bed. Results were inconsistent, and I would usually dose off when I was completely exhausted. Sometimes, I could pull myself together to go to work. During the day, I would not notice the pin pricks because my shoes and socks applied a uniform pressure that tended to lessen my sensitivity.

Since my father’s death in January and accelerated by my mother’s death in April, I’ve been living off reserves (don’t ask me to explain; I’m searching for a concept that doesn’t sound too “New Age-ish”). I attended yoga class in fits and starts, I did not make to the gym either, and each new beginning seemed to start from a more degraded status. Because I had to prioritize my time and energy to take of my job responsibilities and the settling of my parents’ estate, I have not been taking care of myself as well as I should.

This summer, I could feel that things were catching up with me: just run together a string of nights with just 4-5 hours sleep each, and anyone’s performance suffers; and pain medication and sleeping pills did not seem to have an effect. I finally went to my doctor again and we did another round of blood work, which revealed that I was in otherwise good health.

The next step was to see a neurologist, who confirmed the original diagnosis — the condition of idiopathic peripheral neuropathy — the “idiopathic” means that the doctors don’t know what the cause is, and the “peripheral” means that the condition is outside the central nervous system (brain and spinal cord). The neurologist did not find any impairment (grip, balance, coordination, etc.) aside from the pain, and because I can remember the pin prick sensation as far back as 12 years, it’s not something of recent onset. He then ordered up an electromyography and nerve conduction test — basically electrocuting my feet, legs and arms for two hours and measuring the speed of the peripheral nerves. The results showed that the nerve circuits in my feet and legs had a degraded capacity, but no clear cause was identified. I was given a prescription of Gabapentin (a generic drug to treat epilepsy, but also effective for neuropathic pain) and told to ramp up the dosage until it relieved my pain.

Conclusion: After a three-week blitz, Western medicine has determined that whatever the cause, the only option is to treat the symptoms by helping me manage the pain and to monitor my condition to see if it got worse. I could probably consult some more specialists or look for some obscure disease (does Dr. House receive patients from DC?). I’ve consulted with my acupuncturist and he said that he could help with the pain and, perhaps, slow the neuropathy, but did not hold out much hope for reversing it. I am going to have to take ownership of my pain and body, and learn to manage both, which is a trial-and-error process.